Health Services and Delivery Research最新文献

{"title":"Access to and interventions to improve maternity care services for immigrant women: a narrative synthesis systematic review","authors":"G. Higginbottom, C. Evans, M. Morgan, K. Bharj, J. Eldridge, Basharat Hussain, K. Salt","doi":"10.3310/hsdr08140","DOIUrl":"https://doi.org/10.3310/hsdr08140","url":null,"abstract":"Limited evidence suggests experiences of immigrant women accessing and using UK maternity services were mixed but largely poor, and there were few rigorously evaluated interventions focused on improving care.","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"8 1","pages":"1-122"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41606800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding how front-line staff use patient experience data for service improvement: an exploratory case study evaluation","authors":"L. Locock, C. Graham, Jenny King, S. Parkin, A. Chisholm, C. Montgomery, E. Gibbons, Esther Ainley, J. Bostock, M. Gager, Neil Churchill, S. Dopson, T. Greenhalgh, Angela Martin, J. Powell, S. Sizmur, S. Ziebland","doi":"10.3310/hsdr08130","DOIUrl":"https://doi.org/10.3310/hsdr08130","url":null,"abstract":"\u0000 \u0000 The NHS collects a large number of data on patient experience, but there are concerns that it does not use this information to improve care. This study explored whether or not and how front-line staff use patient experience data for service improvement.\u0000 \u0000 \u0000 \u0000 Phase 1 – secondary analysis of existing national survey data, and a new survey of NHS trust patient experience leads. Phase 2 – case studies in six medical wards using ethnographic observations and interviews. A baseline and a follow-up patient experience survey were conducted on each ward, supplemented by in-depth interviews. Following an initial learning community to discuss approaches to learning from and improving patient experience, teams developed and implemented their own interventions. Emerging findings from the ethnographic research were shared formatively. Phase 3 – dissemination, including an online guide for NHS staff.\u0000 \u0000 \u0000 \u0000 Phase 1 – an analysis of staff and inpatient survey results for all 153 acute trusts in England was undertaken, and 57 completed surveys were obtained from patient experience leads. The most commonly cited barrier to using patient experience data was a lack of staff time to examine the data (75%), followed by cost (35%), lack of staff interest/support (21%) and too many data (21%). Trusts were grouped in a matrix of high, medium and low performance across several indices to inform case study selection. Phase 2 – in every site, staff undertook quality improvement projects using a range of data sources. The number and scale of these varied, as did the extent to which they drew directly on patient experience data, and the extent of involvement of patients. Before-and-after surveys of patient experience showed little statistically significant change. Making sense of patient experience ‘data’ Staff were engaged in a process of sense-making from a range of formal and informal sources of intelligence. Survey data remain the most commonly recognised and used form of data. ‘Soft’ intelligence, such as patient stories, informal comments and daily ward experiences of staff, patients and family, also fed into staff’s improvement plans, but they and the wider organisation may not recognise these as ‘data’. Staff may lack confidence in using them for improvement. Staff could not always point to a specific source of patient experience ‘data’ that led to a particular project, and sometimes reported acting on what they felt they already knew needed changing. Staff experience as a route to improving patient experience Some sites focused on staff motivation and experience on the assumption that this would improve patient experience through indirect cultural and attitudinal change, and by making staff feel empowered and supported. Staff participants identified several potential interlinked mechanisms: (1) motivated staff provide better care, (2) staff who feel taken seriously are more likely to be motivated, (3) involvement in quality improvement is itself motivating and ","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42008281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic health records in ambulances: the ERA multiple-methods study","authors":"A. Porter, Anisha Badshah, S. Black, David Fitzpatrick, R. Harris-Mayes, Saiful Islam, Matthew Jones, M. Kingston, Yvette LaFlamme-Williams, S. Mason, K. McNee, H. Morgan, Z. Morrison, P. Mountain, H. Potts, N. Rees, D. Shaw, N. Siriwardena, H. Snooks, R. Spaight, V. Williams","doi":"10.3310/hsdr08100","DOIUrl":"https://doi.org/10.3310/hsdr08100","url":null,"abstract":"Additional co-authors: Nigel Rees, Debbie Shaw, Niro Siriwardena, Helen Snooks, Rob Spaight and Victoria Williams","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"8 1","pages":"1-139"},"PeriodicalIF":0.0,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42622171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multifaceted intervention to reduce antimicrobial prescribing in care homes: a non-randomised feasibility study and process evaluation","authors":"C. Hughes, D. Ellard, A. Campbell, R. Potter, C. Shaw, Evie Gardner, A. Agus, D. O’Reilly, M. Underwood, M. Loeb, Bob Stafford, M. Tunney","doi":"10.3310/hsdr08080","DOIUrl":"https://doi.org/10.3310/hsdr08080","url":null,"abstract":"Declared competing interests of authors: Carmel Hughes is a member of the Health Services and Delivery Research Commissioned Panel. Mark Loeb has worked for the World Health Organization as a consultant to develop antibiotics for an essential list of medicines and algorithms for appropriate antibiotic use. Martin Underwood is a member of National Institute for Health Research (NIHR) Journals Library Editors Group. He was chairperson of the National Institute for Health and Care Excellence accreditation advisory committee from 2013 until March 2017, for which he received a fee. He is chief investigator or co-investigator on multiple previous and current research grants from NIHR and Arthritis Research UK and is a co-investigator on grants funded by Arthritis Australia, Australian National Health and the Medical Research Council. He has received travel expenses for speaking at conferences from the professional organisations hosting the conferences. He is a director and shareholder of Clinvivo Ltd (Tenterden, UK), which provides electronic data collection for health services research. He is part of an academic partnership with Serco Ltd (Hook, UK) related to return-to-work initiatives. He is an editor of the NIHR journal series, for which he receives a fee. He has accepted an honorarium for advice on Research Excellence Framework submission from Queen Mary University of London. He is co-investigator on an Efficacy and Mechanism Evaluation grant, receiving support in kind from Orthospace Ltd (Caesarea, Israel).","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"8 1","pages":"1-150"},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45797061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous infusion practices across England and their impact on patient safety: a mixed-methods observational study","authors":"A. Blandford, D. Furniss, G. Galal-Edeen, G. Chumbley, Li Wei, A. Mayer, B. Franklin","doi":"10.3310/hsdr08070","DOIUrl":"https://doi.org/10.3310/hsdr08070","url":null,"abstract":"Background Intravenous (IV) medication administration has traditionally been regarded to be error-prone with high potential for harm. A recent US multisite study revealed surprisingly few potentially harmful errors despite a high overall error rate. However, there is limited evidence about infusion practices in England and how they relate to prevalence and types of error. Objectives To determine the prevalence, types and severity of errors and discrepancies in infusion administration in English hospitals, and to explore sources of variation in errors, discrepancies and practices, including the contribution of smart pumps. Design Phase 1 comprised an observational point-prevalence study of IV infusions, with debrief interviews and focus groups. Observers compared each infusion against the medication order and local policy. Deviations were classified as either errors or discrepancies based on their potential for patient harm. Contextual issues and reasons for deviations were explored qualitatively during observer debriefs, and analytically in supplementary analyses. Phase 2 comprised in-depth observational studies at five of the participating sites to better understand causes of error and how safety is maintained. Workshops were held with key stakeholder groups, including health professionals and policy-makers, the public and industry. Setting Sixteen English NHS hospital trusts. Results Point-prevalence data were collected from 1326 patients and 2008 infusions. In total, 240 errors were observed in 231 infusions and 1489 discrepancies were observed in 1065 infusions. Twenty-three errors (1.1% of all infusions) were considered potentially harmful; one might have resulted in short-term patient harm had it not been intercepted, but none was judged likely to prolong hospital stay or result in long-term harm. Types and prevalence of deviations varied widely among trusts, as did local policies. Deviations from medication orders and local policies were sometimes made for efficiency or to respond to patient need. Smart pumps, as currently implemented, had little effect. Staff had developed practices to manage efficiency and safety pragmatically by working around systemic challenges. Limitations Local observers may have assessed errors differently across sites, although steps were taken to minimise differences through observer training, debriefs, and review and cleaning of data. Each in-depth study involved a single researcher, and these were limited in scale and scope. Conclusions Errors and discrepancies are common in everyday infusion administration but most have low potential for patient harm. Findings are best understood by viewing IV infusion administration as a complex adaptive system. Better understanding of performance variability to strategically manage risk may be more helpful for improving patient safety than striving to eliminate all deviations. Future work There is potential value in reviewing policy around IV infusion administration to reduc","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"8 1","pages":"1-116"},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42656497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of changing provider remuneration on NHS general dental practitioner services in Northern Ireland: a mixed-methods study","authors":"P. Brocklehurst, M. Tickle, S. Birch, R. McDonald, T. Walsh, T. Goodwin, H. Hill, E. Howarth, M. Donaldson, D. O’Carolan, Sandy Fitzpatrick, Gillian McCrory, Carolyn Slee","doi":"10.3310/hsdr08060","DOIUrl":"https://doi.org/10.3310/hsdr08060","url":null,"abstract":"Background: \u0000Policy-makers wanted to reform the NHS dental contract in Northern Ireland to contain costs, secure access and incentivise prevention and quality. A pilot project was undertaken to remunerate general dental practitioners using a capitation-based payment system rather than the existing fee-for-service system. \u0000 \u0000Objective: \u0000To investigate the impact of this change in remuneration. \u0000 \u0000Design: \u0000Mixed-methods design using a difference-in-difference evaluation of clinical activity levels, a questionnaire of patient-rated outcomes and qualitative assessment of general dental practitioners’ and patients’ views. \u0000 \u0000Setting: \u0000NHS dental practices in Northern Ireland. \u0000 \u0000Participants: \u0000General dental practitioners and patients in 11 intervention practices and 18 control practices. \u0000 \u0000Interventions: \u0000Change from fee for service to a capitation-based system for 1 year and then reversion back to fee for service. \u0000 \u0000Main outcome measures: \u0000Access to care, activity levels, service mix and financial impact, and patient-rated outcomes of care. \u0000 \u0000Results: \u0000The difference-in-difference analyses showed significant and rapid changes in the patterns of care provided by general dental practitioners to patients (compared with the control practices) when they moved from a fee-for-service system to a capitation-based remuneration system. The number of registered patients in the intervention practices compared with the control practices showed a small but statistically significant increase during the capitation period (p < 0.01), but this difference was small. There were statistically significant reductions in the volume of activity across all treatments in the intervention practices during the capitation period, compared with the control practices. This produced a concomitant reduction in patient charge revenue of £2403 per practice per month (p < 0.05). All outcome measures rapidly returned to baseline levels following reversion from the capitation-based system back to a fee-for-service system. The analysis of the questionnaires suggests that patients did not appear to notice very much change. Qualitative interviews showed variation in general dental practitioners’ behaviour in response to the intervention and how they managed the tension between professional ethics and maximising the profits of their business. Behaviours were also heavily influenced by local context. Practice principals preferred the capitation model as it freed up time and provided opportunities for private work, whereas capitation payments were seen by some principals as a ‘retainer fee’ for continuing to provide NHS care. Non-equity-owning associates perceived the capitation model as a financial risk. \u0000 \u0000Limitations: \u0000The active NHS pilot period was only 1 year, which may have limited the scope for meaningful change. The number of sites was restricted by the financial budget for the NHS pilot. \u0000 \u0000Conclusions: \u0000General dental practitioners respond rapidly and consistently to changes in r","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"117 40","pages":"1-138"},"PeriodicalIF":0.0,"publicationDate":"2020-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41250546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of community treatment orders and their outcomes: an observational study","authors":"S. Weich, C. Duncan, L. Twigg, O. McBride, H. Parsons, G. Moon, A. Canaway, J. Madan, David Crepaz-Keay, Patrick Keown, S. Singh, K. Bhui","doi":"10.3310/hsdr08090","DOIUrl":"https://doi.org/10.3310/hsdr08090","url":null,"abstract":"\u0000 \u0000 Community treatment orders are widely used in England. It is unclear whether their use varies between patients, places and services, or if they are associated with better patient outcomes.\u0000 \u0000 \u0000 \u0000 To examine variation in the use of community treatment orders and their associations with patient outcomes and health-care costs.\u0000 \u0000 \u0000 \u0000 Secondary analysis using multilevel statistical modelling.\u0000 \u0000 \u0000 \u0000 England, including 61 NHS mental health provider trusts.\u0000 \u0000 \u0000 \u0000 A total of 69,832 patients eligible to be subject to a community treatment order.\u0000 \u0000 \u0000 \u0000 Use of community treatment orders and time subject to community treatment order; re-admission and total time in hospital after the start of a community treatment order; and mortality.\u0000 \u0000 \u0000 \u0000 The primary data source was the Mental Health Services Data Set. Mental Health Services Data Set data were linked to mortality records and local area deprivation statistics for England.\u0000 \u0000 \u0000 \u0000 There was significant variation in community treatment order use between patients, provider trusts and local areas. Most variation arose from substantially different practice in a small number of providers. Community treatment order patients were more likely to be in the ‘severe psychotic’ care cluster grouping, male or black. There was also significant variation between service providers and local areas in the time patients remained on community treatment orders. Although slightly more community treatment order patients were re-admitted than non-community treatment order patients during the study period (36.9% vs. 35.6%), there was no significant difference in time to first re-admission (around 32 months on average for both). There was some evidence that the rate of re-admission differed between community treatment order and non-community treatment order patients according to care cluster grouping. Community treatment order patients spent 7.5 days longer, on average, in admission than non-community treatment order patients over the study period. This difference remained when other patient and local area characteristics were taken into account. There was no evidence of significant variation between service providers in the effect of community treatment order on total time in admission. Community treatment order patients were less likely to die than non-community treatment order patients, after taking account of other patient and local area characteristics (odds ratio 0.69, 95% credible interval 0.60 to 0.81).\u0000 \u0000 \u0000 \u0000 Confounding by indication and potential bias arising from missing data within the Mental Health Services Data Set. Data quality issues precluded inclusion of patients who were subject to community treatment orders more than once.\u0000 \u0000 \u0000 \u0000 Community treatment order use varied between patients, provider trusts and local areas. Community treatment order use was not associated with shorter time to re-admission or reduced time in hospital to a statistically significant degree. We found no evidence that the effectiveness","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48935456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presenting patients with information on their oral health risk: the PREFER three-arm RCT and ethnography","authors":"Rebecca V Harris, C. Vernazza, L. Laverty, V. Lowers, G. Burnside, Stephen L. Brown, S. Higham, L. Ternent","doi":"10.3310/hsdr08030","DOIUrl":"https://doi.org/10.3310/hsdr08030","url":null,"abstract":"Background: A new NHS dental practice contract is being tested using a traffic light (TL) system that categorises patients as being at red (high), amber (medium) or green (low) risk of poor oral health. This is intended to increase the emphasis on preventative dentistry, including giving advice on ways patients can improve their oral health. Quantitative Light-Induced Fluorescence (QLF™) cameras (Inspektor Research Systems BV, Amsterdam, the Netherlands) also potentially offer a vivid portrayal of information on patients’ oral health. Methods: Systematic review – objective: to investigate how patients value and respond to different forms of information on health risks. Methods: electronic searches of nine databases, hand-searching of eight specialist journals and backwards and forwards citation-chasing followed by duplicate title, abstract- and paper-screening and data-extraction. Inclusion criteria limited studies to personalised information on risk given to patients as part of their health care. Randomised controlled trial (RCT) – setting: NHS dental practice. Objective: to investigate patients’ preferences for and response to different forms of information about risk given at check-ups. Design: a pragmatic, multicentred, three-arm, parallel-group, patient RCT. Participants: adults with a high/medium risk of poor oral health attending NHS dental practices. Interventions: (1) information given verbally supported by a card showing the patient’s TL risk category; (2) information given verbally supported by a QLF photograph of the patient’s mouth. The control was verbal information only (usual care). Main outcome measures: primary outcome – median valuation for the three forms of information measured by willingness to pay (WTP). Secondary outcomes included toothbrushing frequency and duration, dietary sugar intake, smoking status, self-rated oral health, a basic periodontal examination, Plaque Percentage Index and the number of tooth surfaces affected by caries (as measured by QLF). Qualitative study – an ethnography involving observations of 368 dental appointments and interviews with patients and dental teams. Results: Systematic review – the review identified 12 papers (nine of which were RCTs). Eight studies involved the use of computerised risk assessments in primary care. Intervention effects were generally modest, even with respect to modifying risk perceptions rather than altering behaviour or clinical outcomes. RCT – the trial found that 51% of patients identified verbal information as their most preferred form, 35% identified QLF as most preferred and 14% identified TL information as most preferred. The median WTP for TL was about half that for verbal information alone. Although at 6 and 12 months patients reported taking less sugar in drinks, and at 12 months patients reported longer toothbrushing, there was no difference by information group. Qualitative study – there was very little explicit risk talk. Lifestyle discussions were often ","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":" ","pages":"1-126"},"PeriodicalIF":0.0,"publicationDate":"2020-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48300388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to primary and community health-care services for people 16 years and over with intellectual disabilities: a mapping and targeted systematic review","authors":"A. Cantrell, E. Croot, Maxine Johnson, Ruth Wong, D. Chambers, S. Baxter, A. Booth","doi":"10.3310/hsdr08050","DOIUrl":"https://doi.org/10.3310/hsdr08050","url":null,"abstract":"Background: In 2015, approximately 2.16% of adults were recorded as having intellectual disabilities. UK government policy is that adults with intellectual disabilities should access mainstream health services. However, people with intellectual disabilities experience challenges when accessing primary and community health services that can lead to inequalities and shorter life expectancy. \u0000 \u0000Objectives: To map and review the evidence on access to primary and community health-care services for adults with intellectual disabilities and their carers. To identify influencing factors for gaining access \u0000 \u0000to primary and community health-care services. To determine which actions, interventions or models of service provision improve entry access to these services for people with intellectual disabilities and \u0000 \u0000their carers. Finally, to identify the gaps in evidence and provide implications for health care and recommendations for research. \u0000 \u0000Data sources: MEDLINE, The Cochrane Library, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Applied Social Sciences Index and Abstracts (ASSIA) and Education \u0000 \u0000Resources Information Center (ERIC) were searched from 2002 to 2018. \u0000 \u0000Review methods: The mapping review methodology included an extensive literature search, article selection and data extraction of relevant abstracts. Findings from the mapping review informed the scope of the targeted systematic review. Methodology for the targeted systematic review included an extensive literature search informed by the mapping review, article selection, data extraction, quality appraisal and narrative synthesis. \u0000 \u0000Results: The mapping review included 413 studies with data extraction completed on abstracts. The targeted systematic review synthesised the evidence from 80 studies reported in 82 publications. During the review process, the team identified three key points at which people with intellectual disabilities potentially interacted with primary and community health-care services: identifying needs, accessing services and interaction during a consultation. In addition, there were a number of papers about interventions or innovations to improve access. Evidence from the studies was synthesised within the four clusters. Influencing factors were identified: staff knowledge/skills, joint working with learning disability services, service delivery model, uptake, appointment making, carer/support role, relationship with staff, time, accessible information and communication. The influencing factors were cross-cutting through the literature, with certain factors having more importance in certain clusters. \u0000 \u0000Limitations: The main limitation was the weak evidence base. The studies generally had small samples, had study designs that were open to potential biases and measured only short-term outcomes. \u0000 \u0000Conclusions: Health checks were found to help identify health needs and improve the care of long-term conditions. Important factors for a","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"8 1","pages":"1-142"},"PeriodicalIF":0.0,"publicationDate":"2020-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47247259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the enhanced recovery pathway and other factors on outcomes and costs following hip and knee replacement: routine data study","authors":"A. Judge, A. Carr, A. Price, C. Garriga, C. Cooper, D. Prieto-Alhambra, F. Old, G. Peat, Jacqueline Murphy, J. Leal, K. Barker, L. Underdown, N. Arden, R. Gooberman-Hill, R. Fitzpatrick, S. Drew, Mark G. Pritchard","doi":"10.3310/hsdr08040","DOIUrl":"https://doi.org/10.3310/hsdr08040","url":null,"abstract":"1National Institute for Health Research Oxford Biomedical Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK 2National Institute for Health Research Bristol Biomedical Research Centre, Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK 3Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK 4Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford, UK 5GREMPAL Research Group, Musculoskeletal Research Unit, Universitat Autònoma de Barcelona, Barcelona, Spain 6Patient representative 7Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK 8Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK 9Nuffield Department of Population Health, University of Oxford, Oxford, UK 10Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK","PeriodicalId":12880,"journal":{"name":"Health Services and Delivery Research","volume":"8 1","pages":"1-188"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41690806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}